CMS Formulary

Displaying 122891-122900 of 1611142 results.
ID: 122891
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122892
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122893
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 122894
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 122895
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122896
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122897
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122898
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122899
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122900
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30